Provider Demographics
NPI:1497894547
Name:AUSTIN, LINDA L (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:L
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1301 E MCDOWELL RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006
Mailing Address - Country:US
Mailing Address - Phone:602-254-2200
Mailing Address - Fax:602-254-9337
Practice Address - Street 1:1301 E MCDOWELL RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006
Practice Address - Country:US
Practice Address - Phone:602-254-2200
Practice Address - Fax:602-254-9337
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ21329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ146028001OtherAHCCCS
ZMD21329Medicare PIN
AZ146028001OtherAHCCCS
AZMD21329Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER